1991, 11-01 Permit 91007374 MHSPOKANE COUNTY DEPAFFMENT OF BUILDINGS
W.1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99$60
(509) 456-3675
1 certify that I have examined this permit/application, state that the information contained in it and submitted by me or my agent to compile said permit/application is
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTI
provisions included herein and agree to comply with same. All provisions of laws and ordinances gov6rning this type of work will be complied with whether specif
herein or not. I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construes
give authority to violate orcancel the provisions of any state or local law regulating construction, oras a warranty of conformance with the provisions of anystateor to
laws regulating construction. TGNATLIRE OF11 � / ,
OWNER OR GENT " V c(6 CX I APPLICATION f .� �J /
DATE /
PR:O.IECT NUMBER= 0007374 ISSUED PERMIT DATE= ii/0/9i PAGE= &
)�•)ifE>eiE#3r)eii•ri ie ii 3e ,e iE ie ie li•ir •YE Yi iF 3F )t ie fieri# PERMIT INFORMATION ii riie)t,r 3Ef6kaElfliir#?r dr ai ie 3i lr �s je lr )e#ii le ie 9r
SITE STREET= 3504 N FLORA RD PARC:IELO= 06553-059
ADDRESS= SPOKANE WA 9906
PERMIT USE= MOBILE HOME AS CARETAKER RESIDENCE
PLATO= 00204i 'PLAT NAME= PLAT 03 OP WEST FARMS IRRIGATE
BLOCK= LOT= ZONE= i: --A DIST4= G
AREA= 00000003 P/A= A WIDTH= DEPTH= R/W= 60
0 OF BLDGE= i f DWELLINGS= i WATER DIST = CON,SOLIDATED, 1RRG 0
OWNER= CAMPBELL, LEANNA PHONE= 549 92:4 0859
STREET= =504 N FLORA RD
ADDRESS= SPOKANE_ WA 9906
CONTACT NAME= LEANNA CAMPBELL PHONE NUMBER= 509 924 009
BUILDING SETBACKS: FRONT= 540 LEFT== i 00 RIGHT= 25 REAR= 00
)t•A^Atilt'li bl.j�..j(..h..g..jf..){. iiknil k3tA R,4'A N):1h 3t•ir 9&§4'P.' MOBILE HOME PERMIT li'H'A"R'R')<9l$i'iI'ri•H)(kjl'R li'R H'!l"R"a"R"H"H')l'H
CONTRACTOR= OWNER PHONE==
YR/MAKE"- MODEL=
EERIALO= WIDTH= 00 LENGTH= 00 HEIGHT= 00
ITEM DESCRIPTION QUANTITY FEE AMOUNT
------------------------- -------- ------------
INSPECTION FEE: 2 i00.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE 'r 16:.00
iF)e ii i6 if ripe ir3e ie ie ie ie)eS. iF is 3r le ie dr i�:ri#,e ,e ie ie ve iE it PAYMENT SUMMARY die 9E•)r it it ii ie lt.h3e)fie 7e lr#ar ii )i )i ii ie ie )i �c it ii ii
PAYMENT DATE RECEIPT; PAYMENT AMOUNT
i i/ 0/ 9 1 6277 i20 50
---------------
TOTAL
.-.......-'-'------_..--.....TOTAL_ DUE= 7i, TOTAL PAID= 12%50
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
------------------ ------------- ------------ -- -------------
MOBILE HOME PMT 120.50 120,50 .00
--------- ------------ --------------
120.50 '1 2'0+ 547 400
PROCESSED BY: ,_OHN LARSON
PRINTED BY: WENDI: L, GLORIA
THANK rlgl YOU '➢:'A Yi k'91 d134')klt..A.:PiP)!i")i')tR'A'it"H"k r4h lt'A'9E'A-A''$'$dl'.A'!#dE